Under the general direction of the Billing Services Manager, the Director of Business Services, and the Physician Practice Business Office Supervisor, the Practice Billing Specialist will create claims, bill payers, review EOBs, post payments, and provide all follow-up work necessary for account reimbursement, including appeals, patient responsibility statements, and collection efforts. The role may require communication with providers regarding missing information or coding issues.
The Practice Billing Specialist prepares and submits clean claims to various insurance companies electronically or by paper, answers questions from patients and insurance companies, identifies and resolves patient billing complaints, prepares and sends patient statements, evaluates patient's financial status, establishes budget payment plans, and manages delinquent accounts including forwarding to collection agencies and contacting patients.
Responsible for processing payments, translating patient information into medical codes, monitoring coding accuracy and educating staff, investigating and correcting rejected and denied claims, participating in educational activities, and maintaining HIPAA compliance and confidentiality.
This role utilizes software systems such as eCW EHR, Cerner EHR, SSIGroup, and Gateway/Trizetto.
Minimum education: High School or equivalent.
Working knowledge of commercial insurance and government payers.
Biller Certification preferred; coding experience is a plus.
At least two years of hands-on experience in a practice billing setting with strong organizational and follow-up skills.
Experience with RHC billing and familiarity with ACOs and associated quality standards is advantageous.
Proficiency with billing and EHR software such as eCW EHR, Cerner EHR, SSIGroup, Gateway/Trizetto.
Location
Georgia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago